This seminar will provide an overview of the historical law and policy decisions that have shaped the U.S. health care system and are informing current debates about health reform. Students will learn about the structure and functioning of the U.S. health care system, with a focus on how this system is working (or not working) for vulnerable populations (e.g., low-income people living with chronic health conditions). Incorporating varying perspectives, the seminar will discuss and analyze federal and state policy options that the nation has going forward to address the current public health and access to care crisis that is a direct outgrowth of 50 million Americans being without health insurance. The seminar will encourage discourse, dialogue, and debate from all perspectives about U.S. health law and policy choices.
This seminar will include a mix of substantive and skills-based classes. For the substantive classes, we will analyze and discuss key elements of the current U.S. health care system as well as major federal and state law and policy initiatives, including the national health care reform law – the Patient Protection and Affordable Care Act – with a focus on how these initiatives impact access to care for vulnerable populations. For the skills-based classes, the goal is to develop students’ ability to effectively identify, analyze, describe, and advocate for a particular policy issue or objective.
This seminar will begin with an overview and comparison of the health systems currently in place in other democratic countries, to put the U.S. health system into context. Next, we will discuss the origins of the U.S. health system and key policy decisions over the past century that have shaped the current patchwork of public and private insurance coverage options in this country. After providing this international and historical context, we will move to a detailed analysis of the key elements of the current U.S. health system through the lens of its impact on vulnerable populations. We will look at the components of the federal approach to reform, looking first at piecemeal reforms and programs aimed at particular areas or populations and then stepping back to analyze some of the most recent proposals that come closer to a complete overhaul of the current system, including extensive analysis of the Affordable Care Act. Moving from federal health care initiatives to state initiatives, we will look to several case studies that highlight the ways in which states are acting as “laboratories of innovation” to implement sweeping health care reforms.
Finally, we will look at what forces are at play that favor the health policy status quo in this country and then discuss the many avenues that health policy solutions focusing on increasing access to health care can take.
This seminar is open to students interested in health law and policy and its implications on access to care for vulnerable populations, and no background or prerequisites are required. The reading materials for the course will be provided in a course reader, and will include various book chapters, cases, news reports, and scholarly articles that present diverse viewpoints on the topics presented. The course is intended to spark debate between different sides of these often controversial issues, and students will be asked to participate in different in-class role plays and debates.
Rather than an examination, students will be required to submit responses to the readings or relevant news articles via the on-line course blog, prepare for and participate in in-class role playing activities and debates, and prepare short policy briefs. During several weeks of the semester we will also have clinical students present “case rounds” about their clinical work, to introduce the rest of the students to the health policy work currently taking place at HLS through clinical, volunteer, and pro bono opportunities.
Enrollment in the seminar is limited to 20 students, and is open to LLM students by permission.
Some seats are reserved for students enrolled in the fall and winter Health Law and Policy Clinic. Students must be enrolled in the clinic before they can claim one of these reserved seats. A student’s enrollment in a reserved clinical seat is dependent on the student’s enrollment in the Health Law and Policy Clinic. Please see the clinic’s description for more information.